Provider Demographics
NPI:1841522257
Name:KRISHNAPPA, SRINIVASALU (MD)
Entity type:Individual
Prefix:
First Name:SRINIVASALU
Middle Name:
Last Name:KRISHNAPPA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1600 ELDRIDGE PKWY
Mailing Address - Street 2:4004
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-1600
Mailing Address - Country:US
Mailing Address - Phone:918-625-6567
Mailing Address - Fax:
Practice Address - Street 1:1600 ELDRIDGE PKWY
Practice Address - Street 2:4004
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-1600
Practice Address - Country:US
Practice Address - Phone:918-625-6567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No183700000XPharmacy Service ProvidersPharmacy Technician